Diagnosis and management of peripheral lung nodule

Khan, Taha; Usman, Yasir; Abdo, Tony; Chaudry, Fawad; Keddissi, Jean I.; Youness, Houssein

doi:10.21037/atm.2019.03.59

Cited by 38 publications

(48 citation statements)

References 99 publications

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“…Simultaneously, we then found that young people pay more attention to their health than the elderly, which might be explained by the following reasons: (1) young patients are more accessable for physical examination, (2) small sample size of the study, and (3) the lack of insufficient blinding. A previous study has confirmed that SPNs in the upper lobe of the lung are more likely to develop lung cancer than those in the lower lobe, accounting for 1%–5%, 25 possibly due to a higher concentration of inhaled carcinogens from smoking in the upper lobes 26 . As tuberculosis accounted for a relatively high proportion of benign patients in our study, and was prone to occur in the lung upper lobe, the location of nodules in the upper lobe in the lung was not an independent predictor.…”

Section: Discussionmentioning

confidence: 93%

Establishment and validation of a prediction model for the probability of malignancy in solid solitary pulmonary nodules in northwest China

Duan

Wang

Zhang

et al. 2021

Journal of Surgical Oncology

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Background and Objectives To construct a prediction model of solitary pulmonary nodules (SPNs), to predict the possibility of malignant SPNs in patients aged 15–85 years in northwest China for clinical diagnostic and therapeutic decision‐making. Methods The features of SPNs were assessed by multivariate logistic regression, followed by visualization using a nomogram. Hosmer lemeshow was applied to evaluate the fitting degree of the model. The area under the receiver operating characteristic (ROC) curve was identified to determine the discriminative ability of the model. Results Lobulation, spiculation, pleural‐tag, carcinoembryonic antigen, neuron‐specific enolase, and total serum protein were independent predictors of malignant pulmonary nodules (p < .05). Lobulation (100 points) scored the highest in the nomogram, and the Hosmer‐Lemeshow goodness‐of‐fit statistic was 0.805 (p > .05). The area under curve (AUC) of the modeling and validation groups using logistic regression were 0.859 (95% CI, 0.805–0.903) and 0.823 (95% CI, 0.738–0.890), respectively. Moreover, the AUC of our model was higher than that of the Mayo model, VA model, and Peking University (AUC 0.823 vs. 0.655 vs. 0.603 vs. 0.521). Conclusion Our prediction model is more suitable for predicting the possibility of malignant SPNs in northwest China, and can be calculated using a nomogram to determine further treatments.

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Section: Discussionmentioning

confidence: 93%

Establishment and validation of a prediction model for the probability of malignancy in solid solitary pulmonary nodules in northwest China

Duan

Wang

Zhang

et al. 2021

Journal of Surgical Oncology

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“…Peripheral solitary pulmonary nodules (SPN) are the usual manifestations of early peripheral lung cancer. The lesions are single and isolated, and the gaseous lung tissue completely surrounds these lesions[ 13 ]. If the diameter is below 30 mm, there are no symptoms, such as pleural effusion, hilar enlargement, or atelectasis.…”

Section: Discussionmentioning

confidence: 99%

Value of virtual bronchoscopic navigation and transbronchial ultrasound-guided sheath-guided exploration in diagnosis of peripheral lung cancer

Liu¹,

Wang²,

Zhang³

et al. 2020

WJCC

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BACKGROUND Peripheral lung cancer poses a substantial harm to human health, and it is easy to become exacerbated, potentially threatening the life and safety of patients AIM To assess the value of virtual bronchoscopic navigation (VBN) combined with transbronchial ultrasound-guided sheath-guided (EBUS-GS) exploration in the diagnosis of peripheral lung cancer. METHODS A total of 236 patients with peripheral lung cancer (nodule diameter range, 8-30 mm; diagnosed using high-resolution computed tomography) were selected from three centers between October 2018 and December 2019. Patients who underwent EBUS-GS exploration alone were included in a control group, and those who received VBN in combination with EBUS-GS exploration were included in an observation group. The diagnostic rate and total operating time of different subgroups of the two groups were compared, and the time needed to determine the lesion was recorded. RESULTS There were no significant differences in diagnosis rate or total operation time between the two groups ( P > 0.05), and the time needed to determine the lesion in the observation group was less than that of the control group ( P < 0.05). CONCLUSION The combined use of VBN and EBUS-GS exploration technology has little effect on the diagnosis rate and total operation time of peripheral lung cancer, but it significantly shortens the time needed to determine the lesion and is a valuable diagnostic method.

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“…Peripheral pulmonary lesions (PPLs) indicate focal radiographic lesions of opacity with the characteristics of nodules (≤3 cm) or masses (>3 cm). 1 When pulmonary lobectomy is proposed by some guidelines in patients suffering from PPLs with a high risk of malignancy, 2,3 computed tomography (CT) screening research has demonstrated that 18%-34% of such surgical procedures are conducted in patients harboring benign nodules. 4,5 Consequently, correct diagnosis with minimal invasion is strongly favored.…”

Section: Introductionmentioning

confidence: 99%

<p>Endobronchial Ultrasound Combined with Clinical Data for Predicting Malignant Peripheral Pulmonary Lesions</p>

Ren

Zhang

et al. 2020

CMAR

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Introduction: This study was to develop a simple model for predicting malignancy of peripheral pulmonary lesions (PPLs) based on endobronchial ultrasonography (EBUS) and clinical findings. Methods: Patients who had EBUS for PPLs were analyzed and compared on the EBUS imaging characteristics and clinical data. The malignancy prediction model was established by the logistic equation of probability of malignant PPL based on the data of 135 patients. The model was tested on an additional 50 patients for efficiency. Results: Among 135 prospectively enrolled patients, 77 (57%) patients had malignant and 58 (43%) had benign lesions with the size of 36.5±19.9 mm. Univariate analysis demonstrated a significant (P<0.05) difference in the serum CEA (borderline 15 µg/mL) and smoking history between malignant and benign lesions but a non-significant (P>0.05) difference in age (50 years as the cutoff value) and history of extra-thoracic malignancies. Logistic analysis of multiple factors showed that smoking history, serum CEA, borderline, air bronchogram, heterogeneous echo, and anechoic areas were significant (P<0.02) risk factors for malignant lesions. The malignancy prediction model was established by the logistic equation of probability of malignant PPL (P) = l/[l+e-Z ], where Z=−2.986+1.993X 1 +2.293X 2 +l.552X 3 +1.616X 4-2.011X 5 +1.718X 6 , e is the base of the natural logarithm, X 1 is the smoking history, X 2 is the serum CEA, X 3 is the borderline, X 4 is the heterogenicity, X 5 is the air bronchogram, and X 6 is the anechoic area. The receiver operating characteristic curve had an area under the curve (AUC) of 0.926 (95% confidence interval: 0.883-0.969). The sensitivity, specificity, and accuracy were 88.2% (30/34), 75.0% (12/16), and 92.0% (46/50), respectively, for the logistic equation to predict the malignancy. Conclusion: Endobronchial ultrasonography is a safe and practical method, and the model combining EBUS and clinical data can accurately predict the malignancy of peripheral pulmonary lesions.

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Diagnosis and management of peripheral lung nodule

Cited by 38 publications

References 99 publications

Establishment and validation of a prediction model for the probability of malignancy in solid solitary pulmonary nodules in northwest China

Establishment and validation of a prediction model for the probability of malignancy in solid solitary pulmonary nodules in northwest China

Value of virtual bronchoscopic navigation and transbronchial ultrasound-guided sheath-guided exploration in diagnosis of peripheral lung cancer

<p>Endobronchial Ultrasound Combined with Clinical Data for Predicting Malignant Peripheral Pulmonary Lesions</p>

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